Diseases, Disorders information

Heat stroke is a medical emergency. These patients need very aggressive cooling. This may involve packing them in ice externally. It may involve administering cool fluids to every orifice and IV site to bring down their body temperature rapidly. They need to be fluid resuscitated, they are essentially all dehydrated and vasodilated, and they need ongoing supportive care.
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Now there is a specific syndrome in young children that has been reported, of hemorrhagic shock and encephalopathy syndrome. Which is basically unexplained severe hyperthermia in young children without an infectious etiology defined, which is associated with a very significant encephalopathy. These patients develop shock, DIC and actually have a high mortality rate. In the initial series, 100% mortality rate was reported. Now survivors have been reported, but it still does have a high mortality rate. It is uncommon but has been the source of questions in the past.
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Smoke inhalation; another environmental disaster. If you happen to be in a fire you get asphyxiated. Fire consumes oxygen, it leaves what you are breathing to be relatively oxygen-free, and although you are having air exchange you are not getting oxygen to your tissues. You may have a thermal injury, although this is a much less common cause of death, where you actually have flame injury to the tissues. A thermal injury with super-heated environments, gases especially if there is steam involved, you may get airway injury from the high temperatures. This is typically supraglottic. By the time it gets down to your lungs the gases have usually cooled enough that you don’t have burning all the way down your lungs. You may begin to develop airway edema. If you have a child who has stridor following a burn injury, they have soot in their oropharynx, you want to establish an airway quickly before it swells shut. So burns to the lip or nose, soot in the mouth, singed nasal hair, stridor, hoarseness or respiratory distress, are all indications for intubation. Don’t wait and hope that they are going to get better. They are going to get worse before they get better and they need an airway.
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Carbon monoxide; combustion releases carbon monoxide. When it’s in a fire it will be associated with soot and other things. You can get carbon monoxide poisoning in other environments. Exhaust systems of furnaces may dysfunction and everyone in the home may in fact have carbon monoxide poisoning. It’s a colorless, odorless gas so they won’t know it until they are losing consciousness or having changes. We are going to talk a little about the pathophysiology, the diagnosis and the therapy. Again, it’s colorless, odorless, non-irritating gas. Sounds like a pretty good way to kill somebody, to me.